PGR - 1 A Pediatric Case Study of Autism Spectrum Disorder Associated with Germinal Matrix-Intraventricular Hemorrhage, Periventricular Leukomalacia, and Cerebral Palsy.

Abstract

Abstract Objective Germinal matrix-intraventricular hemorrhage (GMH-IVH) is a serious complication of prematurity that places infants at risk for damage to important white matter pathways which can result in periventricular leukomalacia (PVL) and ultimately cerebral palsy (CP). GMH-IVH also increases the risk of developmental and intellectual disabilities for preterm infants, highlighting the need for early detection and treatment. Method This case study presents on the neuropsychological profile of a 4-year-old boy who was born micropremature and had a history of multiple hemorrhages, extensive PVL, and CP in the context of significant developmental and social delays. Results Neuropsychological testing revealed severe impairments in intellectual functioning (Stanford Binet-5 FSIQ = 42, Nonverbal IQ = 43, Verbal IQ = 47; Leiter-3 Nonverbal IQ = 41), adaptive skills, language, social cognition, visuomotor abilities, spatial skills, pre-academic skills, and attention/executive functioning. He scored in the significant range on measures specific to Autism Spectrum Disorder (ADOS-2; CARS-2; SCQ) and behavioral-emotional functioning. Lastly, he exhibited intermittent staring behaviors that were concerning for possible seizure activity. Conclusions Recommendations were made to increase special education services for the child and to modify his academic goals. Recommendations were also given to aid in treatment planning for his referring neurologist and clinical interventions (e.g., ABA, social work, speech/language, occupational therapy, and physical therapy). This case study demonstrates the need for early neuropsychological detection and treatment for children with complications of prematurity during this important period of brain development, particularly as there are higher rates of autism in this population. Prompt detection leads to earlier treatment and better outcomes.